Health Indicator Report of Blood Cholesterol: Doctor-diagnosed High Cholesterol
High blood cholesterol is a major risk factor for heart disease and stroke. It is preventable. If identified early, it can be controlled with medication and lifestyle changes, such as eating a diet low in saturated fat and cholesterol, increasing physical activity, and reducing excess weight. Because high blood cholesterol does not produce obvious symptoms, experts recommend that all adults aged 20 years and older have their cholesterol levels checked at least once every five years to help them take action to prevent or lower their risk of cardiovascular disease.
In 2015, the prevalence of high blood cholesterol continued to be lower among Utah adults than among the general U.S. adult population (24.1% UT, 31.1% U.S.).
Doctor-diagnosed Hypercholesterolemia (High Blood Cholesterol) by Year, Utah and U.S., 1991-2015
NotesAge-adjusted to 2000 U.S. standard population. Note: At the time of this update, the BRFSS U.S. dataset did not include an age variable but did include five age categories up to age 80+ (vs. the typical weighting scheme that includes 85+). Comparisons with both weighting schemes were compared using Utah data, and the difference was about 1/100 of a percentage point. To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2010, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method.
- Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
- U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services
Data Interpretation IssuesDoctor-diagnosed hypercholesterolemia is based on the answer to the question: "Have you ever been told by a doctor, nurse, or other health professional that you have high blood cholesterol?" This question is asked in odd-numbered years. While this question is asked of all respondents, almost one third of respondents reported not having had their blood cholesterol checked in the past five years. This means that the actual prevalence of high cholesterol is probably higher than the numbers reported here. Due to small numbers, data by Utah Small Area are based on combined years. Some of these estimates may be statistically unreliable and should be interpreted with care. Beginning in 2011, BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. This methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. Both of these methodology changes were implemented to account for an increased number of U.S. households without landline phones and an under-representation of certain demographic groups that were not well-represented in the sample. More details about these changes can be found at: [http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf].
DefinitionThe proportion of adults who have ever been told by a doctor, nurse, or other health professional that they have high blood cholesterol.
NumeratorThe number of adults who have ever been told by a doctor, nurse, or other health professional that they have high blood cholesterol.
DenominatorThe total number of survey respondents (BRFSS survey) excluding those with missing or refused values in the numerator.
Healthy People Objective HDS-7:Reduce the proportion of adults with high total blood cholesterol levels
U.S. Target: 13.5 percent
How Are We Doing?In 2015, the age-adjusted percentage of Utah adults who reported being told they had high cholesterol was 24.1% (1 in 4 adults). However, this estimate likely underestimates the actual prevalence because Utah has a lower rate of 5-year cholesterol screens than most states. In 2015 doctor-diagnosed high cholesterol was only significantly different by gender within age group 35-49 (15.3% for females and 23.2% for males). High cholesterol prevalence increased with age. Among Utahns aged 65 and over, 49.2% were diagnosed with high cholesterol. In 2015, none of the estimates for high cholesterol rates by race or ethnicity (Hispanic/non-Hispanic) were statistically different from the state rate.
How Do We Compare With the U.S.?In 2015, the age-adjusted U.S. estimate for high cholesterol was 31.1% of adults. Utah's 2015 rate of high cholesterol (24.1%) was lower than the U.S. rate. In years 2005, 2007, and 2009, Utah had a lower rate of adults reporting 5-year cholesterol screens compared with other states. Nationally, the Centers for Disease Control and Prevention (CDC) documented an increase in cholesterol screening of 4.5 percent during these years. Utah's rate increased by 5.8 percent, but was the second lowest among the 50 states. Due to this low rate of cholesterol screening, it is likely that high cholesterol is under-diagnosed. For more information on how Utah compares to the U.S. and other states for cholesterol screening, please visit [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6135a2.htm].
What Is Being Done?The Healthy Living through Environment, Policy, and Improved Clinical Care Program (EPICC) was formed in 2013, consolidating three Utah Department of Health programs (Diabetes Prevention and Control Program, Heart Disease and Stroke Prevention Program, and the Physical Activity, Nutrition and Obesity Program). The purpose of the consolidation was to ensure a productive, collaborative, and efficient program focused on health outcomes. EPICC aims to reduce the incidence of diabetes, heart disease, and stroke by targeting risk factors including reducing obesity, increasing physical activity and nutritious food consumption, and improving diabetes and hypertension control. The program is organized around four domains: *Domain 1: Epidemiology and Surveillance--gather, analyze, and disseminate data and information and conduct evaluation to inform, prioritize, deliver, and monitor programs and population health. *Domain 2: Policy and Environment--environmental approaches the promote health and support and reinforce healthful behaviors (statewide in schools and childcare, worksites, and communities). *Domain 3: Health Systems--Health system interventions to improve the effective delivery and use of clinical and other preventive services in order to prevent disease, detect diseases early, and reduce or eliminate risk factors and manage complications. *Domain 4: Community Clinical Linkages--Strategies to improve community-clinical linkages ensuring that communities support and clinics refer patients to programs that improve management of chronic conditions. [[br]] The primary program strategies include: *Increasing healthy nutrition and physical activity environments in K-12 schools *Increasing healthy nutrition and physical activity environments in early care and education (childcare/preschool) *Increasing healthy nutrition and physical activity environments in worksites *Improving awareness of prediabetes and hypertension for Utahns *Improving the quality of medical care for people with diabetes and hypertension *Improving the linkages between health care providers and supporting community programs for Utahns with diabetes and hypertension *Improving access and availability to community health programs for Utahns with diabetes, hypertension, and obesity *Improving care and management of students with chronic conditions in Utah schools
Evidence-based PracticesHigh cholesterol is one of the most commonly treated medical conditions. Aggressive treatment focuses on lowering LDL ("bad" cholesterol levels). Lowering LDL cholesterol reduces the risk of coronary heart disease and ischemic stroke. Low cholesterol diet, increased exercise, and statin medications are the first line of treatment.
Health Program InformationIn 2012, the Utah Heart Disease and Stroke Prevention Program published a statistical report titled the Impact of Heart Disease and Stroke in Utah. This report describes overall patterns in cardiovascular disease and risk factors at the state and national levels and among Utah sub-populations (age group, sex, race, ethnicity, and Utah Small Area). To download the full report, please visit [http://www.choosehealth.utah.gov/documents/pdfs/reports/HD_Stroke_Burden_Report2012.pdf].
Page Content Updated On 11/30/2016, Published on 12/12/2016